Healthcare Provider Details

I. General information

NPI: 1407293640
Provider Name (Legal Business Name): THERAPY MANAGEMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2013
Last Update Date: 06/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 MONROE AVE NE
GRAND RAPIDS MI
49505-3313
US

IV. Provider business mailing address

851 PENNIMAN AVE
PLYMOUTH MI
48170-1621
US

V. Phone/Fax

Practice location:
  • Phone: 877-864-8171
  • Fax: 989-509-5965
Mailing address:
  • Phone: 877-864-8171
  • Fax: 989-509-5965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: KELLIE J PEDEN
Title or Position: OWNER
Credential:
Phone: 877-864-8171